Exam Preview for 42219: Persistent Postural Perceptual Dizziness: A

Persistent Postural Perceptual Dizziness: A Common Cause of Chronic Symptoms

Please note: exam questions are subject to change.

1. According to the Bárány Society criteria, which symptom pattern is characteristic of Persistent Postural-Perceptual Dizziness (PPPD/3PD)? Brief spinning vertigo triggered exclusively by head position changes Episodic vertigo associated only with migraine headaches Persistent non-spinning dizziness or unsteadiness worsened by upright posture, motion, and complex visual stimuli Sudden drop attacks associated with fluctuating hearing loss
2. Which clinical finding is most consistent with PPPD rather than a structural vestibular disorder? Progressive unilateral vestibular weakness on caloric testing MRI evidence of cerebellar infarction Positional nystagmus consistent with BPPV Normal vestibular and neuroradiologic findings despite persistent dizziness symptoms
3. Which factor commonly exacerbates symptoms in patients with PPPD? Quiet resting in a dark room Exposure to ototoxic medication only Complex visual environments such as supermarkets, traffic, or scrolling on digital screens Low-frequency auditory stimulation
4. Which statement best describes the relationship between anxiety and vestibular dysfunction in PPPD? Anxiety is unrelated to chronic dizziness symptoms Vestibular symptoms occur only in patients with psychiatric disease Structural vestibular lesions exclude functional dizziness Vestibular disorders may trigger anxiety, and anxiety may in turn worsen dizziness and postural instability
5. Which management approach is most appropriate for patients diagnosed with PPPD? Surgical vestibular ablation Long-term vestibular suppressant medication alone Multidisciplinary treatment including vestibular rehabilitation, CBT, patient counseling, and SSRI/SNRI therapy when indicated Strict avoidance of all visually stimulating environments